The Massachusetts Medical Society (MMS) wishes to be recorded in S.1061
An Act to promote public safety and better outcomes for youths.
The MMS is a professional association of over 23,000 physicians, residents, and medical students across all clinical disciplines, organizations, and practice settings. The Medical Society is committed to advocating on behalf of patients, to provide them a better health care system, and on behalf of physicians, to help them provide the best care possible. The MMS recognizes that social and structural determinants of health play a critical role in shaping health outcomes and perpetuating health disparities. Addressing these determinants is essential not only to the well-being of our patients, but also to the sustainability and equity of our health care system. Accordingly, we support S.1061 as a measure that directly advances public health, health equity, and community safety by promoting more developmentally appropriate, rehabilitative responses for young people.
S.1061 would expand the jurisdiction of the juvenile justice system to include 18- to 20-year-olds. As physicians committed to improving health and advancing equity across the Commonwealth, we view this legislation as a important public health measure that will reduce harm, promote rehabilitation, and strengthen our communities. Extensive research demonstrates that the human brain continues to mature into the mid-twenties, particularly in areas governing impulse control, judgment, and decision-making. Young adults are therefore uniquely receptive to rehabilitative interventions that emphasize accountability, education, and family engagement, which are hallmarks of the juvenile justice system. In contrast, exposure to the adult criminal legal system places young people in punitive environments ill-suited to their developmental needs and associated with worse long-term health outcomes. By aligning our justice system with developmental science, this legislation will help young people grow into healthier, more stable adults—an outcome that benefits individuals, families, and the Commonwealth as a whole.
Involvement in the carceral system has profound and direct impacts on physical and mental health. Young people who are incarcerated, especially in adult facilities, face significantly higher rates of trauma, substance use, depression, suicide, and chronic disease. The public health harms extend beyond the individual, affecting families and entire communities. These risks are compounded by structural racism and bias, which place Black, Latino, and LGBTQ youth at disproportionate risk of arrest, incarceration, and the associated health consequences. By keeping 18- to 20-year-olds within the juvenile system, this bill takes a meaningful step toward mitigating these inequities and promoting healthier futures for all young people.
Evidence clearly shows that a rehabilitative approach works. Since Massachusetts expanded juvenile jurisdiction in September 2013 to include 17-year-olds, juvenile arrests have fallen by 53 percent. This decline also corresponds with steady decreases in court caseloads, detention admissions, and youth commitments, indicating that the system is absorbing the changes without adverse strain.
S.1061 is grounded in this evidence. By allowing older adolescents to be charged as juveniles, this bill would reduce the short- and long-term health harms of legal system involvement. The juvenile system prioritizes interventions like therapeutic programming, educational access, and family engagement, which are proven to reduce reoffending and improve health and social outcomes. It also provides more opportunities for diversion, balancing the need for accountability while avoiding the harmful impacts of incarceration. For those who do become justice-involved, juvenile facilities provide care consistent with pediatric standards, whereas adult prisons and jails are often unequipped to meet even basic medical and mental health needs.
This reform also holds implications for equity and economic stability. Black and Latino youth are vastly overrepresented in the adult criminal system, and adult convictions carry lifelong collateral consequences—limiting access to housing, employment, and higher education. These structural barriers directly worsen health outcomes, perpetuating cycles of poverty and illness. By ensuring that 18- to 20-year-olds remain within the juvenile system, the Commonwealth can help disrupt these inequities and foster pathways toward stable, healthy adulthood.
From a physician perspective, the connections between justice policy and public health are clear. Policies that emphasize rehabilitation and reintegration reduce chronic disease, substance use, and mental health crises, while strengthening the social determinants of health like education, housing, employment, and community connection. S.1061 represents an evidence-based opportunity to protect the health of our youth and, in doing so, enhance public safety and community well-being across the Commonwealth.
Importantly, Massachusetts would not be alone in taking this next step. Vermont enacted legislation in to include 18-year-olds in its juvenile system by 2020 and 19-year-olds by 2027, and early results have shown positive outcomes for youth and communities. Other states, including Colorado, Connecticut, Illinois, Nebraska, Virginia, and Washington, have pending legislation to similarly raise the age to include 18- to 20-year-olds. This growing national trend reflects broad recognition that aligning justice policy with developmental and health science leads to better outcomes for young people and safer, more equitable communities.
For these reasons, we urge the committee to act favorably on this legislation and continue the Senate’s leadership in adopting evidence-based, equitable approaches to youth justice and public health. Thank you for your consideration of our comments.
View a PDF version of this testimony here.
